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01/12/2012

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Daniel S. Goldberg

You'll find nice support for your claims regarding #3 in Powers and Faden's health sufficiency model of social justice, which they deploy to claim that our paramount obligation is to break or perhaps avoid intensifying the "densely-woven patterns of disadvantage" in which the worst off find themselves. Insofar as anti-smoker hiring policies almost unquestionably do intensify such patterns in a variety of ways (e.g., stigma, unemployment, income), they violate the mandate and are to be avoided if at all possible.

How the conclusion regarding densely-woven patterns of disadvantage being paramount follows from their premises is of course a different question entirely . . . but I really do like the theory. I think it has a lot going for it, and have been somewhat surprised that it has been acknowledged but not really applied much in the literature (Full disclosure: I am trying to do exactly this!)

Paul Kelleher

I'm not a fan of sufficientarian theories, but you are right that they nicely highlight the ways in which disadvantages cluster. On this, also see _Disadvantage_ by Wolff and de-Shalit.

Daniel S. Goldberg

May I ask why?

Paul Kelleher

This does a pretty good job: http://plato.stanford.edu/entries/egalitarianism/#5.1

Also, sufficientarians tend to ignore need to explain why one party has sufficientarian-based duties to other parties. They explain well why its very bad indeed to be below sufficiency; I'm less impressed with their accounts of how we get from the grave badness to the obligations of others.

Bill Gardner

A question I have raised a couple of times in this discussion: If it is wrong for an employer to discriminate on smoking, is it also wrong for her to discriminate on skill?

RRBILL

As a COPD sufferer leaving a difficult marriage to a chain smoker, I believe an employer has an obligation to maintain a safe working place. Remember, a drunk can't do as much damage to you as a smoker, unless he gets in a car or pukes on you.

Paul

Bill asks: "If it is wrong for an employer to discriminate on smoking, is it also wrong for her to discriminate on skill?"

No, it is not wrong per se to discriminate on skill. You are right that we are all made better off by allowing employers wide discretion in hiring, since they know their business needs best and can promote them most efficiently.

Note, however, that there are some important exceptions to this employer prerogative. The Americans with Disabilities Act is one, and so are racial anti-discrimination laws. Each of these forbids a kind of preferential hiring that might well have promoted firm-level efficiency. (This isn't the case so much anymore with the hiring of blacks, but there surely was a time when hiring a minority would have been disruptive to the previously white-only work environment.)

So despite the introduction of firm-level inefficiency, we do recognize some instances in which social justice justifies the introduction of some inefficiency. (We also recognize limits to this kind of trumping, e.g. when we require employers to give only "reasonable accommodate" to individuals with disabilities.) To the degree that I have been making a social justice-based argument in behalf of smokers, I can draw on these other cases as support. I have not, of course, argued that smokers deserve the same kinds and degree of protection that blacks and individuals with disabilities deserve. Indeed, I said I would support higher health care premiums for smokers as a nudge away from smoking. I certainly would not support the same for the disabled or for minorities exposed to the social determinants of disease. I think this shows that the disagreement between you and me may be one of degree (albeit a significant degree) rather than of kind. (I think this also goes for the disagreement between you and Harold.) As I say in the post above, "Erecting greater barriers to employment is, however, going too far in my opinion."

Bill Gardner

I do think that the disagreement is a matter of degree. In one of the earlier posts, I discussed maternity benefits. Like disability rights and laws against racial discrimination, I think these cases show that one can make successful arguments against employer prerogatives. We just disagree about whether smoking is such a case.

Paul

I also note that I haven't seen great data on the productivity loss associated with smokers. The USA Today article says only: "'There's also an impact on productivity,' she says, because smokers take more breaks." Breaks are something an employer has complete control over, right?

Bill Gardner

I do not know how good the productivity data are; and of course that is important. However, employers do not have complete control over anything, and exerting control is itself costly. Employees who need to be policed are not what you want.

Paul

Good point. Still, doesn't seem all that difficult/costly to me to enforce a prohibition on excessive smoke breaks outside.

James

Bill: “Smoking is a vice that benefits no one. It's not a candidate for a lifestyle choice that we want to protect through employment laws.”

Paul, I’d like to begin with Bill’s comment. The “we” in the statement seem to be doing much pontificating. The question is who are these “we” and what actual authority and competence do they have for arbitrating life, death, and health – or anything for that matter?

It never ceases to amaze that the “pontificators” typically have no grasp of even recent history, particularly as it pertains to their pontificating.

Anti-smoking/tobacco is not new. It has a long, sordid history. The idea that “smoking has no value” is as old as antismoking, i.e., the last 400 years. A more recent addition is the idea of nicotine “addiction”. The argument goes…. If smoking has no benefits, then why do people continue to smoke? Because they’re “addicted”; addicted to what? Well….. um…. nicotine.

In America, this “argument” was peddled by the Temperance (questionable religious leanings) Movement since the mid-1800s. It was then picked up by a more dangerous group from the late-1800s – the Eugenics (physician-led) Movement.

What can be said of the TM and EM is that they represented the most dangerous type of fanatic – the “world-fixer” fanatic. All sorts of baseless, inflammatory claims were made about tobacco (and alcohol). Seeing themselves as “world fixers”, the fanatics’ goal is to coerce/terrorize/terrify the public into conformity, usually through progressively more absurd, inflammatory lies and coercive policies.

Here’s some background on antismoking in early-1900s America, all of it pre-dating the more recent concoction of secondhand smoke “danger”.
http://www.americanheritage.com/content/thank-you-not-smoking
http://www.historylink.org/index.cfm?DisplayPage=output.cfm&File_Id=5339

Led by physicians, eugenics was fraudulently peddled as “scientific” and “scholarly”. It was embraced/funded by the mega-wealthy (e.g., Rockefeller, Ford, Carnegie) and the “educated” class. Eugenics had the ear of the legislature. The eugenics promise was that disease, crime, and poverty would be eradicated. Rather, it brought out the worst in the human potential, e.g., bigotry, racism, cruelty, brutality. It might surprise you that employment discrimination against smokers also occurred at this time (e.g., Ford) as a point of a neurosis/bigotry bandwagon.

James

Anti-tobacco/alcohol reared their heads in pre-Nazi and Nazi Germany, again as a point of the eugenics framework.
http://www.bmj.com/archive/7070nd2.htm

Although its most virulent manifestation, it is important to note that the Nazis didn’t invent eugenics. It was popularized in America. German eugenicists (and Hitler) were students of American eugenics. There was a close relationship between American and German eugenicists and between American and German industrialists who were supporters/funders (e.g., Ford, Rockefeller) of eugenics. Antismoking (and anti-alcohol) didn’t suddenly appear in German society with Nazism. Eugenics ideas were gaining increasing influence in German society through the 1920s.

James

The current antismoking crusade had its formal beginnings in the mid-1970s.
See Godber Blueprint http://www.rampant–antismoking.com

The crusade begins with a throwback to a century-old “definitions”. It also involved the standard eugenics personnel – physicians, biologists, statisticians, behaviorists (although they no longer refer to the social-engineering mentality as eugenics). The crusade also has the same social-engineering extermination (eradication of tobacco use) goal reminiscent of the eugenics mentality. It also uses the same vulgar denormalization/propaganda methodology. It also relies on population-level statistics (statisticalization of life), many of which were developed by eugenicists, e.g., Karl Pearson, for population control, i.e., social engineering.

Never referring to anything positive and only referring to negatives (often contrived) is part of the denormalization process. Physicalists are only obsessed with the physical – health reduced to biology. They have no grasp of any other dimension (e.g., psychological, social). In fact, they have such a blatant disregard for anything other than their deranged world view and social-engineering goals, that they will bulldoze their way through all else. That’s what makes them dangerous. The incessant inflammatory propaganda unfortunately produces a neurosis/bigotry bandwagon effect that many, including politicians and employers, are happy to unquestioningly jump on – just like early last century. And much multi-dimensional damage is done.

James

The question can well be asked how this is benefiting the health of those who smoke, those who dare defy the orders of a self-installed, physicalist elite. The social-engineering intent is clear: Conform – quit smoking – or we’ll make life progressively more difficult for you.

Consider the situation of patients, including elderly patients, having to venture off entire hospital grounds – usually in their night attire and in all weather – for a cigarette. What but bigotry born of questionable ideology is responsible for this circumstance? Where is the outrage from the medical profession that patients should be forced into such a situation? It’s just not there. That should be incredibly troubling.

Consider employment discrimination. The bulk of the discrimination is coming from medical and educational institutions. It is ideologically motivated. It follows the Godber Blueprint that such institutions should be nonsmoking “exemplars” for the rest of society, akin to a cultic priesthood.

Antismoking groups have been pushing for employment discrimination since the 1970s. They have concocted all sorts of “rationalizations” for the bigoted conduct, e.g., smokers are less healthy, they cost more in insurance, etc. Employer groups were not making such claims. It is only as the bigotry bandwagon has picked up speed that other employers are now willing to jump on the bandwagon using the rationalizations provided to them by antismoking groups. The situation is obscene.

James

A little more on the eugenics framework:

Eugenics, a physicalist/materialist framework, views humans as a “herd” that can be engineered along particular physical dimensions, much in the same way as other animals. Although it is notorious for the racial/heredity/breeding dimension, eugenics also has a behavioral dimension. For example, in attempting to rear the best cattle, not only is breeding an issue, but also what the cattle are fed, their [physical] environment, and “behaviors”. In applying this to humans, along the behavioral dimension, physicalism is anti-tobacco/alcohol (these are viewed as only body poisons that detrimentally affect physical performance), dietary prescriptions/proscriptions, and physical exercise. What makes eugenics eugenics – the fascist dimension – is not just the philosophical perspective, but that a self-installed elite made up primarily of physicians should impose/enforce this biological reductionist perspective/edicts on the population at large.

The greatest concentration of eugenicists post-WWII was in America. They were never brought to account for anything: America never resolved its eugenics past. Physicalism is a lowest-common-denominator perspective and of limited repertoire. This is how physicalists “reason”; it is impossible to just “drop” the entire perspective. Eugenicists didn’t just drop their perspective post-WWII. They certainly dropped the racial dimension, not only because their “heredity trees” were thoroughly flawed, but it was, and still is, a very “hot” issue. The eugenicists also dropped the “E”[ugenics] word and emphasized the behavioral dimension which has come to be referred to as “healthism”: It is eugenics by another name. It took only a number of decades – by the late-1970s – for the obsession with physical health – health reduced to only a biological phenomenon – to dominate proceedings again. Although most in contemporary public health wouldn’t have a clue as to what eugenics might even refer to, along the behavioral dimension, they are in fact practicing eugenics. Public health courses and bureaucracies are dominated by physicalism and the medical model.

We currently see all of the standard eugenics “traits” – health reduced to biology, domination by physicalists, obsession with [flimsy] statistics (the term “eugenics” was coined by the statistician Francis Galton, and quite a number of currently used statistics were developed by eugenicists for population-level analysis/control, e.g., Karl Pearson), obsession with shallow, divisive “cost analyses” declaring certain groups as “burdens” to society, and the vulgar practice of denormaliztion/propaganda to achieve fascist social-engineering goals. In a critical regard, antismoking is but a symptom. The actual “beast” is the shallow, demonstrably dangerous, physicalist framework that has legitimized antismoking and other points of social control. Physicalism and the medical model dominate government health bureaucracies around the world. This is where the primary damage has been done.

Although religious groups, to their shame, have since been brought “on board”, the current antismoking crusade is in the eugenics tradition. As can be seen from the World Conferences on Smoking & Health, which is the basis and starting point for the current crusade, involves the standard eugenics personnel – physicians, biologists, statisticians, and those trained in the medical model. Although Godber was not an identified eugenicist, his view on smoking – just an “addiction”, no benefits and only detriments, to be eradicated from society – is the classical eugenics view of smoking. There was nothing peculiar about Godber’s view of smoking; he was a fascist physicalist.

James

With antismoking well along, healthism (eugenics) is attempting to extend its reach to other behaviors it wants control of, e.g.,
http://dickpuddlecote.blogspot.com/2012/01/precedent-what-precedent.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+DickPuddlecote+%28Dick+Puddlecote%29

Consider this modern incarnation of the obsessed-with-control, intrusive eugenics mentality and conditions for employment:

“The clinic tracks its employees’ blood pressure, lipids, blood sugar, weight and smoking habits. If any of these are what the clinic calls “abnormal,” a doctor must certify that the employee is taking steps to get them under control. Otherwise, no insurance rebate. The idea is to force employees to have regular conversations with their doctors about wellness. If they participate, they can lock in the rates they were paying two years ago. The savings amount to many thousands of dollars.”
http://www.washingtonpost.com/blogs/ezra-klein/post/the-promise-and-peril-of-wellness/2011/08/25/gIQAGzPfkL_blog.html


Consider, too, this from New York which, together with California, has become physicalist “hot spots”:

“The city’s goals for the Partnership for a Healthier New York are in line with our ongoing strategies of promoting healthy eating and physical activity and discouraging tobacco, excessive alcohol use and consumption of sugar-sweetened beverages,” a spokeswoman said. “Specific proposals, however, are still in the planning phase.”
http://blastmagazine.com/the-news/bloomberg-plans-to-limit-alcohol-sales-and-advertising/

Referred to are the classical eugenics obsessions along the behavioral dimension together with the incessant eugenics slogan of a “healthier” society.

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